PEDIATRICS Vol. 42 No. 6 December 1968, pp. 986-989
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SMALLPOX VACCINATION: BEFORE OR AFTER ONE YEAR OF AGE?

John M. Neff M.D.1 and J. Michael Lane M.D.1

1 Department of Pediatrics, The Johns Hopkins Hospital, Baltimore, and the Smallpox Eradication Program, National Communicable Disease Center, Atlanta, Georgia

Data have been reported recently indicating that complications following smallpox vaccination occur more frequently in children less than 1 year old than in any other age group. A review of illnesses attributed to smallpox vaccination in England and Wales from 1951 to 1960 demonstrated that dermal complications, particularly generalized vaccinia, occurred two to three times as frequently in children vaccinated before the first birthday as in any other childhood age group.1,2 A review of smallpox vaccination complications in the United States in 1963 yielded similar results.3,4 As a result, the American Academy of Pediatrics Committee on the Control of Infectious Diseases and the Public Health Service Advisory Committee on Immunization Practices have recommended that primary smallpox vaccination be deferred until after the first birthday.5,6 Despite this, many physicians have expressed reluctance to adopt this recommendation as was most evident by the general comments made at the recent panel on immunization at the meetings of the American Academy of Pediatrics in October 1967 and by letter to members of the Smallpox Eradication Program at the National Communicable Disease Center. The purpose of this paper is to review briefly the arguments for and against routine smallpox vaccination in children under 1 year of age.

The principal objections to deferring vaccination until after the first birthday are as follows:

1. If vaccination is not routinely practiced during the first several well-baby clinic visits, many children, particularly those from clinics in the large cities. might not return for subsequent clinic visits and therefore might not have the benefit of a smallpox vaccination.




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L. D. Polk
Best Age for Smallpox Vaccination: More Data Available, Still More Needed
Clinical Pediatrics, March 1, 1970; 9(3): 126 - 127.
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